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Ways to Improve Rural Healthcare Delivery in Challenging Times

by Jim Coleman, CHC SVP of Southeast Hospital Operations


Rural and community hospital leaders – at the forefront in meeting community healthcare needs – frequently encounter challenges that may significantly impact operations and an organization’s long-term financial viability. From variations in patient mix to marketplace mergers and legislative reform, the environment continues to change.


To better position your facility for success, here are some best practice tips to strengthen access to care and delivery of services. Market customization, operational performance, and collaboration opportunities should be at the top of the list.


Customize your hospital’s action plan to your market


Use market demographics and payer mix data to think “outside the box” – every community is different. What works for one hospital may not be right for another. Adopt a strategic approach to evaluating new services and programs. Here are a few specific ideas that have worked for several CHC Consulting clients:

  • For markets with a high percentage of Medicare beneficiaries, heart disease, diabetes, and pulmonary conditions are highly prevalent, and a majority of those beneficiaries have multiple chronic conditions. If your market includes a high percentage of older adults with diabetes, a wound care program could be an appropriate service offering. To help keep more elderly patients with heart and lung conditions healthy and active, cardiac and pulmonary rehabilitation services may be the answer.
  • For an aging demographic, depression and age-related illnesses often amplify the need for older adults and their families to seek specialized geropsychology care. Consider providing these services in both inpatient and outpatient settings
  • For rural hospitals seeking to increase the frequency and speed of specialty services, telemedicine technology provides clinical healthcare to many remote communities. Telemedicine extends specialized physician care to areas without the need for an onsite physical presence. Telemedicine can be particularly helpful for stroke patients who need prompt neurology services in order to achieve the best possible outcome.

Plan for the future


Annual strategic planning is vital to long-term success. The process should include an environmental assessment reviewing marketplace health needs along with medical staff planning. Proactive retention, succession planning and recruitment efforts are especially important in smaller markets where it can take longer to fill vacant positions.


Improve operational performance


Labor is the largest portion of a hospital’s budget. This means it’s critical to closely monitor and manage labor. Analyze staffing and match your workforce to the services needed; research scheduling options and cross-training opportunities to capitalize on efficiency. Could nurse practitioners, physician extenders or others benefit the hospital or community? In addition to labor, supply costs are one of the fastest-growing hospital cost centers. Carefully review your facility’s potential for savings on supplies and pharmaceuticals through a group purchasing organization (GPO) that specializes in community hospitals. Also, look closely at your revenue cycle for opportunities to improve revenue capture and collections.


Team up with area providers and agencies to meet community needs


Collaborative efforts including clinical affiliations with other hospitals or systems can improve population health management and care delivery. For instance, an affiliation agreement could bring a needed physician specialist to your community, a reasonable alternative to recruiting and supporting a medical practitioner on a full-time basis.


Government support can also improve access to community-based health care to broaden the services you provide. State and federal grant dollars support clinical and preventive services such as mammograms; funding is available for telemedicine services and health information technology as well.


Learn more about CHC Consulting solutions including CHC Hospital Operations Services, CHC Strategy Services, and CHC Supply Trust, a GPO just for community hospitals.

Tags: Community Health Needs Assessment, Hospital Management, Hospital Performance Improvement, Operational Assessment , Operational Improvement, Productivity Assessment, Supply Chain
Calling Community Hospitals: A New Era of Opportunity

By Mike Williams,  President and CEO, CHC

As we usher in 2017 with our country’s new administration, it’s not surprising that hospitals, healthcare providers, insurers, and consumers alike are asking “what’s next?” related to healthcare. There’s no question that some changes will occur, although they won’t happen overnight. Many details are forthcoming in the weeks and months ahead.


Regardless of the road in front of us, we must continue to position community and rural hospitals in optimal fashion. CHC will be looking at innovative ways to help community hospitals during these times of change, by lending our expertise, and upholding our mission to guide, support and enhance the mission of community hospitals and healthcare providers.


Strong community hospitals are critical to the vitality of entire populations, especially in rural environments, because they support both the health and economy of the communities they serve. Here are some top-line recommendations to stay the course for continued success, even with impending healthcare reform changes on the horizon:

  • Assess your market position. As a smaller community hospital, this may be a good time to examine relationship opportunities with additional organizations. Could you benefit from optimizing connections with other providers through affiliations or clinical relationships? Are existing services duplicated in your market? Be creative in exploring new associations to position your hospital confidently and strategically.
  • Reduce operational expenses. Maintain or reinvigorate your existing productivity efforts. Monitor key productivity measures, including FTEs per occupied bed. Do you have the right FTEs at the right place at the right time? Also, consider supply chain optimization from an operational perspective. Are you paying too much? Selecting the right group purchasing organization can help streamline your processes and yield optimal supply savings and support, making this a short-term critical success factor.
  • Evaluate your facility’s clinical strength. Look to your IT department for clinical outcomes documentation, and partner with medical staff members to review opportunities for improvement. Examine your HCAHPS scores to determine if there are ways to enhance patient experience.

Even with health care changes ahead, I’m confident community hospitals can persevere by focusing on and optimizing their strength and position as we welcome the New Year.


Learn more about strategies for success moving ahead in 2017.



Tags: Affordable Care Act, Healthcare Reform , Hospital Management, Hospital Performance Improvement, Operational Improvement, Strategic Direction
Managing Organizational Risk: Ways to Keep Your Hospital Safe

by Brian Doerr, CHC SVP Information Technology & Security and Privacy Officer

In this era of electronic data, we’ve come to expect that personal information stored electronically will remain private, accessible only on a “need-to-know” basis to those you identify. But what happens when organizational data becomes available to others as a result of cyber attacks? As an industry, hospitals face particular challenges.


In fact, health care organizations top the list of the most cyber-attacked industries, followed by manufacturing, financial services and the government. Data breaches place private patient data at risk, and HIPAA standards and compliance audits don’t adequately address security issues.


Some of the reasons why health care security risks have steadily increased include:

  • Enhanced access to data via the web and remote devices;
  • Application sprawl, as applications are brought in to satisfy niche requests and unused applications are not decommissioned;
  • Use of mobile and embedded systems such cell phones, laptops, pumps, printers, copiers and more;
  • Limited resources and staff expertise to address growing security needs.

Although the healthcare industry has taken steps to manage IT intrusions, risk management ultimately falls to health systems, hospitals and physician practices. Based on my experience working with these front-line providers, here are some best practice tips to quickly identify, reduce, and manage hospital risk while balancing safety and access to data.

  • Be proactive. It’s not a matter of IF but rather WHEN your organization will be attacked - have a plan in place to quickly identify and mitigate threats.
  • Connect IT security to organizational risk. Reframe the conversation on IT security as a significant organizational risk, beyond the IT function or “checkbox” compliance. Include hospital leadership and an IT steering committee in evaluating the business risks of seemingly small IT implementations to large scale capital investments.
  • Study security roles. Do you really have a Chief Information Security Officer? Perhaps you have an IT Director and/or Security Officer, and they are different individuals. Do they have the training needed to manage security? You may want to re-evaluate positions and governance structure based on a risk/security focus.
  • Monitor data flow. Ensure data is secure at every stage of the workflow, from data flowing through the network, to endpoint devices. Confirm that the network and systems are logging activity and are consistently monitored. Conduct monthly/quarterly penetration testing and incident response exercises and earn from testing outcomes.
  • Analyze the IT environment. Simplify systems whenever possible. Standardize remote access methods.
  • Complete tactical modifications. Review processes and systems needed to improve security, such as 2-factor authentication and single sign-on services. Also, evaluate devices used in clinical settings and their need for full internet access. Ensure all devices with data stored locally are encrypted.
  • Communicate and educate. You can’t communicate “too much.” Inform end-users, management, and board members about cyber-security risks and stress their critical role in protecting the organization. Include education on cyber and physical security as part of orientation, and don’t forget ongoing communication with end-users. Let the community know what the facility is doing to protect their data.

Learn more about CHC Information Management Services including IT technology and security.

Tags: Cyber attack, Hacking, IT Security, Malware, Technology
Executive Recruitment for Interim Management: Easing the Transition

by Laurie Breedlove, CHC SVP of Human Resources


Managing organizational change presents extraordinary challenges, particularly when the change involves replacing a chief executive officer following their departure. For smaller community hospitals in transition, interim leaders can help fill this gap. An interim executive may be someone close to retirement, a leader seeking a different work-life balance, or an experienced, skilled executive unable to relocate for a permanent role where travel is an option.


An interim can devote time and attention to their role alleviating work overloads on others, bring objectivity to a new assignment through an unbiased perspective, and bring experience, enthusiasm and optimism to the job. A leader with a desire to effect change and improve financial and clinical outcomes on a temporary, full-time basis can be a valuable change agent, positioning the hospital for success moving ahead and laying the groundwork for recruitment of a permanent CEO.


Gary Kendrick, for example, has been a hospital administrator since 1980. Through CHC, he has served as interim CEO for several CHC hospitals, filling a significant void until a permanent CEO has been identified.


"Each new hospital is an adventure,” Kendrick says. “The best part about being an interim executive is the opportunity to apply decades of experience as a hospital leader to help steer a hospital's future. There's often lots of work to do, so it's a job that requires rolling up your sleeves to do whatever may be needed. It's a privilege to engage the local hospital Board and work with CHC in several areas. Whether we’re working on improving operations or finances, recruiting a new physician or evaluating how care is delivered, these efforts often go the distance to improve the hospital. When I leave the community, I know they're in a better place."


Understanding how to select and prepare for an incoming interim – a CEO or another executive – will help ensure a smooth leadership transition. Here are some “must-have” tips to follow.


Finding the interim you need.

CHC has a long tradition of helping hospitals locate and place experienced interim executives to fill key leadership positions until permanent candidates are found. This support is invaluable to hospital Board members, who often have business careers in the community that are not healthcare related. CHC specializes in finding an interim executive with just the right combination of talent and skills to address an organization’s customized need. The result? The hospital benefits from a renewed sense of commitment with a new leader, along with the varied experience they bring to the table.


Support for an incoming interim.

Candidates should clearly understand the expectations of the role. The hospital Board should be engaged in clarifying the role of the CEO for an incoming interim; for other executives such as a CFO or CNO the hospital CEO should take the lead in communication. Hospital leaders and managers must perceive the interim as a part of their team ¬– not a “temporary” person.


Communicate regularly with key stakeholders.

Steady, ongoing communication between an interim executive and hospital managers is critical, including regular meetings with individual managers and monthly department manager meetings. When an interim executive is placed by CHC Consulting at a client hospital, CHC meets regularly with the interim to support and facilitate hospital operations and initiatives on an ongoing basis.


Although change can be challenging, following these ideas can help ease the transition as a new leader arrives. In the long run, the hospital and the community both benefit.


Learn more about CHC Consulting Management Services including the placement of interim CEOs and other executives, along with operational assessment services to identify opportunities for operational, clinical and financial improvement.

Tags: Executive Placement, Hospital Management, Hospital Staffing, Interim Executive, Staffing
Physician Engagement Strategies: The Role of Physician Liaisons

Bryan Chandler, Vice President of Business Development, Baptist Hospitals of Southeast Texas


Physicians say that “feeling engaged” with a health care organization is crucial to job satisfaction, a finding documented consistently in survey research. And in a time of physician shortages and competition between hospitals and health systems to attract top physician talent, engagement can ultimately affect a doctor's decision to stay in their current position or seek a new one.

Improved participation and buy-in among physicians can generate inpatient and outpatient referrals and help bolster the hospital's image as a community-centered, leading-edge provider. When you engage physicians as partners, both parties benefit.


At Baptist Hospitals of Southeast Texas, our physician engagement strategies include a robust physician relations program with these goals in mind. Service, accessibility, and accountability are among the program’s guiding principles.


A skilled physician liaison is the cornerstone of any effective physician engagement strategy. This role requires a motivated individual dedicated to the value of physician relationships – someone who possesses excellent follow-up and communication skills. Here are some tips to help you identify the best physician liaison candidates and set them up for success.


Hire the right person. This is a high-energy role. Excellent verbal and written communication skills are “must-haves” for a physician liaison. Knowledge of the market area and local dynamics, as well as an understanding of physician specialties, is critical to cultivate physician-to-physician and hospital-to-physician relationships. Your physician liaison will establish and maintain connections for professional referrals and follow up to close the loop on tasks. He or she must understand what’s expected, why it’s important, and be motivated to fulfill expectations. Your ideal candidate is a team player with a servant heart.


Create C-suite accessibility. A physician liaison needs ready access to C-suite leaders, including the CEO. It’s an integral component that can’t be overlooked. Physicians should feel their efforts are valued and appreciated, backed by a team of administrators including the liaison working together regularly on their behalf. Issues and concerns must be heard and resolved promptly.


Document activity and measure results. To monitor progress and recognize opportunities for improvement, the physician liaison should compile weekly summary reports. Documents should identify physician contacts, meetings, details on discussions, and follow-up actions.


Share physician operations/utilization reports. As valued team members, liaisons must have access to physician utilization reports and related operational data. They may be aware of the reasons why particular physician referral patterns have changed. Regular interaction with physicians can be useful in planning ahead. For instance, if a liaison learns a doctor will be on vacation for a month, sharing this news with hospital administrators and department managers would allow the hospital to plan ahead proactively, perhaps making adjustments in staffing.


Inform and educate physicians and physician office staff representatives about new hospital services or changes to existing services. Communicate personally with physicians and office staff members to clarify and reinforce any changes in policies or procedures. This builds trust, enhancing your engagement efforts.


Establish a solid working relationship with service line directors to address identified problems. It’s all about teamwork. Physician liaisons may not have the ability to solve a particular issue, but they can share concerns voiced by physicians with department managers and others who can handle the problem. Afterward, inform doctors that their concerns were indeed heard, addressed and solved.


Share the love. Encourage hospital department heads and managers to accompany physician liaison representatives on visits to physician offices. Say “thank you” to physicians and office staffs for their support. And think out of the box - always strive for better ways to communicate with your doctors. Create a culture to serve a common purpose.


Learn more about CHC Physician Alignment Strategies to enhance physician relationships.

Tags: Hospital-Physician Alignment, Physician Recruitment

CHC in the Spotlight